Dr. M.J. Bazos, MD.
syndrome is commonly referred to as WPW. WPW is a condition in which the
ventricles of the heart are electrically stimulated to contract out of sequence
with the rest of the heart. The atria of the heart normally receive a signal
contract and force blood into the
ventricle. The ventricle is properly filled before it contracts to send its
blood out from the heart. If it is electrically excited out of order, the
ventricle contracts before it has been completely filled with blood. This is an
arrhythmia called pre-excitation. It can occur on either side of the
heart. WPW is the most common type of pre-excitation syndrome. It causes the
heart to beat too fast (tachycardia).
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This condition is caused by
an abnormal electrical pathway leading down to the ventricle from the atria. It
can occur because of congenital abnormalities (problems present at birth), heart
valve problems, hyperthyroidism, or hypertrophic cardiomyopathy (heart muscle
disease). Persons with WPW often have no symptoms except those related to the
medical condition that may have caused the WPW. Sometimes symptoms of heart
palpitations (irregular, pronounced, rapid beats) cause the heart to beat faster
than usual for no apparent reason. You may have fainting or spells of
lightheadedness. About half of persons with WPW never have symptoms. WPW is not
rare, but because many persons with the condition never have symptoms, it is
only found when you undergo an electrocardiogram (ECG) for another reason. The
diagnosis of WPW is made on the basis of a characteristic pattern on an ECG.
Your diet does not generally affect this condition, but a healthy low-fat diet
is generally recommended for anyone with a heart condition.
with this condition but no symptoms do not need treatment. They live as long as
persons with normal hearts. Persons with symptoms should undergo an ECG while
the symptoms are happening so that the physician can check the electrical
pattern of the heart. Some patterns may necessitate hospitalization for
intravenous medications to control the symptoms. Patients with symptoms not
controlled with medications may need to undergo cardioversion (which means
shock) or ablation (which means removal) of the electrical pathways. Patients
with symptoms of WPW frequently are able to stop the tachycardia by using one of
several maneuvers. Straining (as if lifting something heavy) may slow the rapid
heart rate. Gently massaging the carotid artery in the neck for a few seconds or
applying a cold, wet towel to the face for a few minutes may slow the heart
rate. These techniques should be tried as soon as symptoms are felt for best
results. Persons with frequent, recurrent symptoms may need medications.
Medications for WPW are used either to manage the condition causing the
arrhythmia or to control the response of the ventricle to the abnormal
electrical pathway. Medications used to treat recurrent symptoms of WPW include
atenolol, amiodarone, quinidine, procainamide, or propranolol. The side effects
of the medications should be monitored. Each of these medications can cause
nausea, vomiting, or diarrhea. Each may lower the blood
and may cause additional
arrhythmias. Atenolol and propranolol are beta-blockers and should be used with
caution by persons with diabetes or asthma. They may decrease the ability to
exercise because they prevent the heart from beating too fast. Quinidine may
cause fever, rash, or cinchonism (ringing in the ears, dizziness, headache).
Procainamide may cause a rash, fever, or joint pain.
•Learn the maneuvers
used to control tachycardia.
your medications as prescribed.
•Have a stress (exercise)
test performed before starting any exercise
•Do not forget to
take your medications on a regular schedule, that is, at the same time each
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•If you have new or
worsening symptoms such as uncontrolled rapid heartbeat, fainting, shortness of
breath or chest pain.
•If you have
side effects of your medications.